Individual
DR. DAVID LEWIS SLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10,000 BAY PINES BLVD., BAY PINES, FL 33744
(727) 398-6661
Mailing address
8144 128TH ST, SEMINOLE, FL 33776-3605
(727) 393-0248
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PY5032
FL
103TA0700X
Adult Development & Aging Psychologist
PY5032
FL
103TC0700X
Clinical Psychologist
PY5032
FL
103TH0100X
Health Service Psychologist
Primary
PY5032
FL
Other
Enumeration date
08/20/2006
Last updated
09/11/2025
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